Journal of midwifery & women's health最新文献

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An Integrated Approach to Address Perinatal Mental Health Within an Obstetrics Practice. 在产科实践中采用综合方法解决围产期心理健康问题。
Journal of midwifery & women's health Pub Date : 2024-06-23 DOI: 10.1111/jmwh.13658
Christina L Felten, Kayla S Smith, Melissa B Aylesworth
{"title":"An Integrated Approach to Address Perinatal Mental Health Within an Obstetrics Practice.","authors":"Christina L Felten, Kayla S Smith, Melissa B Aylesworth","doi":"10.1111/jmwh.13658","DOIUrl":"https://doi.org/10.1111/jmwh.13658","url":null,"abstract":"<p><p>Outpatient perinatal care providers (one certified nurse-midwife, one nurse practitioner, and one physician assistant) at a high-volume, suburban health system in southeastern Pennsylvania developed and implemented a care model to identify and care for patients at risk for perinatal and postpartum mental health conditions. The program, Women Adjusting to Various Emotional States (WAVES), was created to bring the most up-to-date, evidence-based treatment recommendations to patients while addressing the increased demand placed on the health care system by pregnant and postpartum patients in need of psychiatric services. WAVES is a specialized program offered for anyone who is pregnant or up to one year postpartum who is struggling with mental health symptoms or concerns. Perinatal mood and anxiety disorders have become one of the most prevalent pregnancy ailments, yet mental health is not always addressed during routine prenatal care visits. Common obstacles to patients obtaining mental health care during pregnancy include lack of access, clinician gaps in knowledge, and stigma surrounding diagnoses. WAVES offers a method to empower perinatal providers with the education and tools to address this need. The model outlines how to appropriately assess, diagnose, manage, or refer patients for mental health services. Patient feedback has been overwhelmingly positive, and this novel care model shows great promise for the future of perinatal care. The development of integrated programs like WAVES may be a valuable resource to help combat the perinatal mental health epidemic.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Examining Cesarean Among Individuals of Advanced Maternal Age in Nurse-Midwifery Care. 研究助产士护理中高龄产妇的剖腹产情况。
Journal of midwifery & women's health Pub Date : 2024-06-10 DOI: 10.1111/jmwh.13656
Antita Kanjanakaew, MinKyoung Song, Martha Driessnack, Elise N Erickson
{"title":"Examining Cesarean Among Individuals of Advanced Maternal Age in Nurse-Midwifery Care.","authors":"Antita Kanjanakaew, MinKyoung Song, Martha Driessnack, Elise N Erickson","doi":"10.1111/jmwh.13656","DOIUrl":"https://doi.org/10.1111/jmwh.13656","url":null,"abstract":"<p><strong>Introduction: </strong>Cesarean rates are rising, especially for individuals of advanced maternal age (AMA), defined as aged 35 or older. The Robson 10-Group Classification System (TGCS) facilitates assessment and comparison of cesarean rates among individuals in different settings. In midwifery-led care, in which pregnant people are typically healthier and seek a vaginal birth, it is unknown whether individuals of AMA have different antecedents leading to cesarean compared with younger counterparts. This study aimed to examine antecedents contributing to cesarean using Robson TGCS for individuals across age groups in midwifery care.</p><p><strong>Methods: </strong>This study was a secondary analysis of 2 cohort data sets from Oregon Health & Science University (OHSU) and University of Michigan Health Systems (UMHS) hospitals. The samples were individuals in midwifery-led care birthing at either OHSU from 2012 to 2019 or UMHS from 2007 to 2019.</p><p><strong>Results: </strong>A total of 11,951 individuals were studied. Overall cesarean rates were low; however, the rate for individuals of AMA was higher than the rate of their younger counterparts (18.30% vs 15.10%). The Robson groups were similar; however, the primary contributor among AMA individuals was group 5 (multiparous with previous cesarean), followed by group 2 [nulliparous with labor induced or prelabor cesarean], and group 1 [nulliparous with spontaneous labor]. In contrast, the primary contributors for younger individuals were groups 1, 2, and 5, respectively. In addition, prelabor cesarean and induced labor partly mediated the relationship between AMA and cesarean among nulliparous individuals, whereas prelabor cesarean was the key contributor to cesarean among multiparous people.</p><p><strong>Discussion: </strong>The cesarean rate in midwifery-led care was low. Using Robson TGCS provided additional insight into the antecedents to cesarean, rather than viewing cesarean as a single outcome. Future studies should continue to use Robson TGCS and investigate antecedents to cesarean, including factors influencing successful vaginal birth after cesarean in individuals of AMA.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identifying Drivers and Barriers to Precepting Midwifery Students: "A Little Part of Me Lives on in Each Student Midwife". 确定助产士学生实习的动力和障碍:"每个助产士学生身上都有我的影子"。
Journal of midwifery & women's health Pub Date : 2024-06-07 DOI: 10.1111/jmwh.13654
Julie Blumenfeld, Amy Alspaugh, Lindsay Wright, Laura Lindberg
{"title":"Identifying Drivers and Barriers to Precepting Midwifery Students: \"A Little Part of Me Lives on in Each Student Midwife\".","authors":"Julie Blumenfeld, Amy Alspaugh, Lindsay Wright, Laura Lindberg","doi":"10.1111/jmwh.13654","DOIUrl":"https://doi.org/10.1111/jmwh.13654","url":null,"abstract":"<p><strong>Introduction: </strong>Increased access to midwifery care is one strategy that could improve perinatal health outcomes and help address the maternal health crisis in the United States. A modifiable barrier to increasing the workforce is greater access to midwifery preceptors for clinical training. The objective of this research is to use the socioecological framework to identify midwives' perceptions of the barriers and facilitators to precepting students in clinical areas.</p><p><strong>Methods: </strong>Midwives attending a preceptor education and training workshop series responded to 3 different questions at the end of each session: (1) What makes precepting midwifery students challenging? (2) What makes precepting midwifery students possible? and (3) What makes precepting midwifery students worthwhile? Responses were coded to align with the socioecological framework, which distinguishes individual, interpersonal, community, institutional, and policy-level influences.</p><p><strong>Results: </strong>Midwives' responses were spread across the levels of the socioecological model except for policy. Participants identified institutional influences such as support as factors that made precepting feasible, both individual and interpersonal factors such as time constraints as areas that presented challenges to precepting, and community factors, like the joy of sharing midwifery, contributing to what made precepting worthwhile.</p><p><strong>Discussion: </strong>Multiple levels of influence were identified in the preceptor process. Participants were internally motivated to precept while also articulating that to make precepting possible, there is a need for support from both colleagues and the greater systems within which they worked. Further studies are needed to investigate an ecosystem that facilitates an effective and sustainable model for midwifery precepting. Additionally, there is a need for efforts to engage and educate midwives in clinical practice about government advocacy that could actualize policy initiatives to support clinical midwifery education.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Conservative Interventions for Urinary Incontinence on Postpartum Women: A Systematic Review and Meta-Analysis. 产后妇女尿失禁的保守干预:系统回顾与元分析》。
Journal of midwifery & women's health Pub Date : 2024-05-28 DOI: 10.1111/jmwh.13653
Lixia Chen, Ying Han, Liang Wang, Han Zhang, Yanan Zheng, Rui Zhang, Ge Meng, Yin-Ping Zhang, Daihong Ji
{"title":"Conservative Interventions for Urinary Incontinence on Postpartum Women: A Systematic Review and Meta-Analysis.","authors":"Lixia Chen, Ying Han, Liang Wang, Han Zhang, Yanan Zheng, Rui Zhang, Ge Meng, Yin-Ping Zhang, Daihong Ji","doi":"10.1111/jmwh.13653","DOIUrl":"https://doi.org/10.1111/jmwh.13653","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary incontinence (UI) is common in postpartum women and can lead to a reduced quality of life and withdrawal from fitness and exercise activities. Conservative management interventions such as pelvic floor muscle training (PFMT), use of vaginal cones, and biofeedback have been recommended as first-line treatment. We aimed to explore the effects of conservative interventions on UI rate, severity, and incontinence-specific quality of life in postpartum women with UI.</p><p><strong>Methods: </strong>Nine databases were searched from inception to August 2022: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, Wanfang, China National Knowledge Infrastructure, China Biological Medicine, and VIP Journal Integration Platform. Randomized controlled trials examining the effects of conservative interventions on postpartum UI were included.</p><p><strong>Results: </strong>Initial searches produced 1839 results, of which 17 studies were eligible. All included studies had a low to moderate risk of bias. Supervised PFMT and use of a vaginal cone were more effective than individual PFMT in decreasing rates of UI (odds ratio, 0.29; 95% CI, 0.14-0.61). Individual PFMT combined with acupuncture (mean difference, -1.91; 95% CI, -2.46 to -1.37) or electroacupuncture and supervised PFMT combined with moxibustion were more effective than individual supervised PFMT alone in improving the severity of symptoms. Furthermore, electrical stimulation and biofeedback combined with acupoint stimulation or core training were more effective than electrical stimulation and biofeedback alone. For improving the incontinence-specific quality of life, supervised PFMT was more efficacious than individual PFMT; electrical stimulation and biofeedback plus core training were more beneficial than electrical stimulation and biofeedback alone.</p><p><strong>Discussion: </strong>Supervised PFMT and use of a vaginal cone were more beneficial in decreasing rates of UI compared with individual PFMT. Superior effects in decreasing UI severity may be achieved by combining PFMT or electrical simulation and biofeedback with other therapies. Electrical stimulation and biofeedback plus core training, as well as supervised PFMT, are most effective in improving incontinence-specific quality of life. Further research is required to provide more evidence on the efficacy of these therapies.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of Obstetric Violence and Patient Choice: Factors Associated With Episiotomy. 产科暴力和患者选择的作用:外阴切开术的相关因素。
Journal of midwifery & women's health Pub Date : 2024-05-24 DOI: 10.1111/jmwh.13655
Mounika Polavarapu, Dorian S Odems, Sativa Banks, Shipra Singh
{"title":"Role of Obstetric Violence and Patient Choice: Factors Associated With Episiotomy.","authors":"Mounika Polavarapu, Dorian S Odems, Sativa Banks, Shipra Singh","doi":"10.1111/jmwh.13655","DOIUrl":"https://doi.org/10.1111/jmwh.13655","url":null,"abstract":"<p><strong>Introduction: </strong>In the United States, 1 in 6 women reports obstetric violence in the form of physical and verbal abuse, coercion, and lack of informed consent. Despite recommendations against routine episiotomy, its use in the United States remains notable and varies considerably. This study aimed to analyze the various forms of obstetric violence associated with undergoing an episiotomy and having a choice in undergoing an episiotomy.</p><p><strong>Methods: </strong>Data from the cross-sectional Listening to Mothers in California survey were analyzed using weighted sample. Logistic regression models were conducted to compute adjusted odds ratios (aORs) and 95% CIs for undergoing episiotomy and having a choice in it.</p><p><strong>Results: </strong>Overall, 21% of the respondents reported undergoing an episiotomy, and 75% of them reported not having a choice in undergoing this procedure. After adjusting for covariates, feeling pressured to induce labor (aOR, 1.31; 95% CI, 1.28-1.35) and to use an epidural analgesia (aOR, 1.82; 95% CI, 1.77-1.88) increased the odds of undergoing an episiotomy. Having a midwife during childbirth significantly reduced the odds of an episiotomy. Respondents who indicated being handled roughly by health care providers were 95% less likely to have a choice in receiving an episiotomy (aOR, 0.05; 95% CI, 0.04-0.06).</p><p><strong>Discussion: </strong>This is the first study to examine other forms of obstetric violence as correlates of episiotomy and having a choice in it. Standardized institutional measures against obstetric violence, patients' ability to make autonomous decisions through informed consent, and engaging midwives could decrease medically unnecessary labor procedures and associated complications.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leading Stressors and Coping Strategies Associated With Maternal Physical and Mental Health During the Extended Postpartum Period. 产后延长期与产妇身心健康相关的主要压力和应对策略。
Journal of midwifery & women's health Pub Date : 2024-05-23 DOI: 10.1111/jmwh.13641
Lorraine O Walker, Nicole Murry, Heather Becker, Yang Li
{"title":"Leading Stressors and Coping Strategies Associated With Maternal Physical and Mental Health During the Extended Postpartum Period.","authors":"Lorraine O Walker, Nicole Murry, Heather Becker, Yang Li","doi":"10.1111/jmwh.13641","DOIUrl":"https://doi.org/10.1111/jmwh.13641","url":null,"abstract":"<p><strong>Introduction: </strong>A critical gap exists in understanding stressors and coping that affect women's health beyond 6 weeks postpartum. Using new stressor and coping scales tailored to postpartum women, we examined the relationship of postpartum-specific stressors and coping to women's physical and mental health between 2 to 22 months after childbirth.</p><p><strong>Methods: </strong>A total of 361 women of diverse race, ethnicity, and functional abilities recruited through clinical and online methods completed online surveys that included Sources of Stress-Revised subscales, such as overload, changes after pregnancy, and low support resources; Postpartum Coping Scale subscales, such as self-regulation, self-care, and health promotion; Patient-Reported Outcomes Measurement Information System Global Health, covering physical and mental health dimensions; and social demographic items. Analyses included hierarchical linear regression models adjusted for social factors.</p><p><strong>Results: </strong>Education and employment were the only social factors associated with physical and mental health, respectively. After adjusting for social factors, overload (P < .001) and coping through health promotion (P = .020) were the only additional variables associated with physical health. After adjusting for social factors, overload (P < .001) and low support resources (P = .002) and coping through self-care (P = .036) were the only additional variables associated with mental health. Thus, being overloaded was the key stressor associated with decreases in physical and mental health. Health promotion was associated with increases in physical health, and self-care was associated with increases in mental health.</p><p><strong>Discussion: </strong>These findings point to directions for health care and community interventions to promote health for postpartum women under stress. Strengths of our study include application of stress and coping scales tailored to postpartum women, whereas a limitation is use of a cross-sectional design.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Social Safety for Black Women in Perinatal Health Care: A Concept Analysis. 黑人妇女在围产期医疗保健中的社会安全:概念分析。
Journal of midwifery & women's health Pub Date : 2024-05-09 DOI: 10.1111/jmwh.13642
Kadeeja S Murrell, Julie Fleury
{"title":"Social Safety for Black Women in Perinatal Health Care: A Concept Analysis.","authors":"Kadeeja S Murrell, Julie Fleury","doi":"10.1111/jmwh.13642","DOIUrl":"https://doi.org/10.1111/jmwh.13642","url":null,"abstract":"<p><strong>Introduction: </strong>Non-Hispanic Black women and their infants experience the worst pregnancy-related outcomes in the United States. Social safety is a health-relevant resource found in environments communicating safety, connectedness, inclusion, and protection. Approaches promoting social safety may be particularly relevant to preventing adverse perinatal health outcomes among Black women. However, there remains a lack of conceptual clarity. The purpose of this concept analysis was to provide a theoretical clarification of the concept social safety for Black women within perinatal health care.</p><p><strong>Methods: </strong>PubMed, PsycINFO, and CINAHL were searched using Boolean search strategy. Retrieved articles were managed in Zotero. Duplicates were removed, and each article was assessed and categorized by both investigators. Articles reporting Black women's perinatal health care experiences were included. Thematic analysis guided by Rodgers' evolutionary method identified defining attributes, antecedents, and consequences of social safety in perinatal care for Black women.</p><p><strong>Results: </strong>Social safety for Black women is defined as the process of feeling understood, respected, cared for, and in control in perinatal health care settings that make space, care for, and recognize strengths, thereby cultivating safety and empowerment.</p><p><strong>Discussion: </strong>Social safety offers actionable insights for practice and research that have the potential to drive positive change in perinatal care delivery for Black women. Developing interventions and measurements that are valid, reliable, and reflect social safety are essential to promote positive experiences and equity in health care practices and policies.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Birth Experience Among Black Women in the United States: A Qualitative Meta-Synthesis. 美国黑人妇女的生育经历:定性元综合。
Journal of midwifery & women's health Pub Date : 2024-04-01 DOI: 10.1111/jmwh.13628
Elizabeth J Spurlock, Rita H Pickler
{"title":"Birth Experience Among Black Women in the United States: A Qualitative Meta-Synthesis.","authors":"Elizabeth J Spurlock, Rita H Pickler","doi":"10.1111/jmwh.13628","DOIUrl":"https://doi.org/10.1111/jmwh.13628","url":null,"abstract":"<p><strong>Introduction: </strong>There are striking disparities in perinatal health outcomes for Black women in the United States. Although the causes are multifactorial, research findings have increasingly identified social and structural determinants of health as contributors to perinatal disparities. Maltreatment during perinatal care, which is disproportionately experienced by Black women, may be one such contributor. Qualitative researchers have explored Black women's perinatal care experiences, but childbirth experience data has yet to be analyzed in-depth across studies. The aim of this meta-synthesis was to explore the birthing experience of Black women in the United States.</p><p><strong>Methods: </strong>PubMed, Embase, PsycINFO, and CINAHL databases were searched. Inclusion criteria were qualitative research studies that included birth experience data shared by self-identified Black or African American women who had given birth in the United States. Exclusion criteria were reports that did not include rich qualitative data or only included experience data that did not specify the race of the participant (eg, data pooled for women of color). The search began February 2022 and ended June 2022. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to appraise the research. Results were synthesized using content analysis.</p><p><strong>Results: </strong>Fifteen studies met inclusion criteria. Main themes included (1) trust: being known and seen; (2) how race influences care; (3) preserving autonomy; and (4) birth as trauma.</p><p><strong>Discussion: </strong>Fragmented care resulted in reports of poor birth experiences in several studies. Open communication and feeling known by perinatal care providers was influential in improving childbirth experiences among Black women; these themes are consistent with existing research. Further prospective research exploring relationships among these themes and perinatal outcomes is needed. Limitations of this report include the use of content analysis and meta-synthesis which may lose the granularity of the original reports; however, the aggregation of voices may provide valuable, transferable, actionable insight that can inform future supportive care interventions.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140338286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Qualitative Exploration of Self-Advocacy Experiences of Black Women in the Perinatal Period: Who Is Listening? 黑人妇女围产期自我辩护经历的定性探索:谁在倾听?
Journal of midwifery & women's health Pub Date : 2024-04-01 DOI: 10.1111/jmwh.13630
Teresa Hagan Thomas, Savannah Vetterly, Elizabeth B Kaselitz, Willa Doswell, Betty Braxter
{"title":"A Qualitative Exploration of Self-Advocacy Experiences of Black Women in the Perinatal Period: Who Is Listening?","authors":"Teresa Hagan Thomas, Savannah Vetterly, Elizabeth B Kaselitz, Willa Doswell, Betty Braxter","doi":"10.1111/jmwh.13630","DOIUrl":"https://doi.org/10.1111/jmwh.13630","url":null,"abstract":"<p><strong>Introduction: </strong>Black women face poor maternal health outcomes including being over 3 times more likely to die from pregnancy complications than White women. Yet the lived experience of how these women self-advocate has not been clearly explored. The goal of this cross-sectional qualitative study was to describe the lived experiences of Black women advocating for their needs and priorities during the perinatal period.</p><p><strong>Methods: </strong>Between January and October of 2022, we recruited Black women from obstetric clinics, research registries, and community advocacy groups who were either in their third trimester of pregnancy or within a year postpartum. Participants completed one-on-one interviews describing their experiences of self-advocacy. These data were analyzed using descriptive content analysis approaches that summarized women's experiences by iteratively creating major themes and subthemes that encapsulate their self-advocacy descriptions.</p><p><strong>Results: </strong>Fifteen Black women completed interviews. Major themes and subthemes describing women's experience of self-advocacy were the following: (1) carrying a burden with subthemes of having to be good and easy, not trusting health care information and providers, and being dismissed; (2) building comfort with health care providers with subthemes of trusting I have a good provider, comfort in knowing they understand, and wanting low-touch, high-concern care; and (3) advocating for my child and myself when I need to with subthemes of going with the flow, becoming informed, pushing to ask questions, and balancing being proactive and pushy.</p><p><strong>Discussion: </strong>Women reported self-advocating mainly due to experiences related to the burdens associated with not trusting providers and health care information. These findings provide clarity to how women carefully balance between ensuring their health is taken seriously while not jeopardizing their health or that of their newborn. This study offers promising directions to support Black women in advocating for their perinatal health care needs and values.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140338285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effects Of Transcutaneous Electrical Nerve Stimulation Applied in the Early Postpartum Period After Cesarean Birth on Healing, Pain, and Comfort. 剖腹产后产后早期经皮神经电刺激对愈合、疼痛和舒适的影响
Journal of midwifery & women's health Pub Date : 2024-03-12 DOI: 10.1111/jmwh.13625
Esra Sabancı Baransel, Sümeyye Barut, Tuba Uçar
{"title":"The Effects Of Transcutaneous Electrical Nerve Stimulation Applied in the Early Postpartum Period After Cesarean Birth on Healing, Pain, and Comfort.","authors":"Esra Sabancı Baransel, Sümeyye Barut, Tuba Uçar","doi":"10.1111/jmwh.13625","DOIUrl":"https://doi.org/10.1111/jmwh.13625","url":null,"abstract":"<p><strong>Introduction: </strong>This study was conducted to determine the effects of transcutaneous electrical nerve stimulation (TENS) applied in the early postpartum period after cesarean birth on incision site healing, postoperative recovery, pain, and comfort.</p><p><strong>Methods: </strong>This randomized, single-blind, placebo-controlled study was conducted with 138 women (TENS group n = 46, placebo group n = 46, control group n = 46) who gave birth by cesarean between January and September 2023. TENS was applied twice at a frequency of 100 Hz with a pulse width of 100 microseconds, at 10 to 12 and 14 to 16 hours after birth, for 30 minutes each. Outcomes were measured with the Postoperative Recovery Index; Redness, Edema, Ecchymosis, Discharge, and Approximation Scale; Visual Analogue Scale; and Postpartum Comfort Questionnaire. Outcomes between groups were compared postintervention, correcting for baseline using analysis of covariance. The study was registered at www.</p><p><strong>Clinicaltrials: </strong>gov (NCT05991921).</p><p><strong>Results: </strong>Mean scores for postoperative recovery were significantly lower (improved) in the TENS group (113.58) compared with the placebo and control groups (134.67, 136.61; P < .001). The postoperative recovery subscales (psychological symptoms, physical activities, appetite symptoms, bowel symptoms, general symptoms) were also significantly decreased in the TENS group compared with the placebo and control groups. Similarly, mean scores for postpartum comfort, and the corresponding physical comfort, psychospiritual comfort, and sociocultural comfort subscales, were significantly improved in the TENS group (110.26) compared with the placebo and control group (83.80, 81.19; P < .05).</p><p><strong>Discussion: </strong>TENS application can be preferred as an alternative method to increase pain control, recovery, and patient comfort after cesarean birth.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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